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P Eschwege

Publications and source records attributed to P Eschwege.

34 records · Page 2Linked to original sources
PubMed1996

[Double kidney-total pancreas transplantation with bladder reimplantation. 25 cases].

Twenty five double kidney-pancreas transplantations were performed according to the total pancreas transplantation technique with drainage of exocrine secretions into the bladder via a vesicoduodenostomy. 72% of kidney-pancreas grafts were functional at one year and 59% were functional at four years. The authors observed a slightly higher rejection rate (0.56 versus 0.34) and a higher incidence of urinary tract infection (60% versus 35%) following double pancreas and renal transplantation than after isolated renal transplantation. Complications were rare: two venous thromboses and two cases of urethritis requiring of rediversion of the duodenum into the intestine. These good results, comparable to those reported in the international registry, reflect the value of the pancreatic and renal transplantation technique using a total pancreas drained into the bladder. It would probably be preferable to transplant patients earlier, when chronic renal failure secondary to insulin-dependent diabetes induces end-stage renal failure and the need for haemodialysis.

Adolescent↗
PubMed1996

Radical nephrectomy for renal cell carcinoma 30 mm. or less: long-term follow results.

PURPOSE: We investigated the clinical and pathological features, and long-term followup of patients with radical nephrectomy for renal cell carcinoma of 30 mm. or smaller and a normal contralateral kidney. MATERIALS AND METHODS: Between 1973 and 1993, 74 patients 29 to 83 years old (average age 60) underwent radical nephrectomy for renal cell carcinoma of 30 mm. or smaller. Average followup was 101 months (range 10 to 236). Of the 74 tumors 21 were stage pT1, 36 stage pT2 and 12 stage pT3 (all 69 stag N0 to NxM0), while 5 were stages pT1 to 3, N1 or M1. A total of 27 patients died during follow-up. Of 11 patients who died of disease progression 5 had metastatic disease initially. RESULTS: Overall survival rates were 73% at 5 years, 55% at 10 years and 38% at 20 years. Cancer-specific survival rates without the 5 patients with stage N1 or M1 disease were 91% at 5 years, and 80% at 10 and 20 years. For the group with nonmultifocal renal cell carcinoma, stage NO to Nx and/or MO, the cancer-specific survival rates were 93% at 5 years, and 81% at 10 and 20 years. For the group with multifocal renal cell carcinoma, stage NO to Nx and/or MO, the cancer-specific survival rate was 75% at 5, 10, and 20 years. There was a significant survival difference between the nonmultifocal and multifocal renal cell carcinoma groups at 5 years (p<0.05) but not at 10 and 20 years. CONCLUSIONS: Small renal cell carcinoma is definitively not a benign disease and a tumor of 30 mm. or smaller does not mean there is no risk of metastatic or multifocal disease.

Adult↗
PubMed1996

Occurrence and treatment of kidney graft lithiasis in a series of 1500 patients.

In a series of 1500 patients transplanted between 1976 and 1992, 12 patients presented urinary calculi. The symptoms presented included obstructive anuria in 3 patients and abdominal pain in 1 patient. There were 8 asymptomatic patients. The risk factors were mainly hyperparathyroidism and non-absorbable sutures. The occurrence of renal graft calculi is now ten times less frequent than in the 1980s. In all, 5 of the patients were treated using incisional surgery, 5 with ESWL and 4 using ureteroscopy; a double J stent was inserted for the 3 cases of obstructive anuria. Nine patients are currently calculus-free and 2 have relapsed. One asymptomatic patient was not treated. The renal function of these 12 patient was not modified and no hypertension was noted after treatment. Calculi are generally asymptomatic when they are diagnosed by ultrasonography and in our experience they can be treated using ESWL or by ureteroscopy. In our opinion all patients can be treated successfully but with a high rate of relapse if the causal factors are not treated.

Adult↗
PubMed1996

Insertion of a double pigtail ureteral stent for the prevention of urological complications in renal transplantation: a prospective randomized study.

PURPOSE: Urologists successfully use ureteral stents to protect the ureterovesical anastomosis in nontransplant patients. MATERIALS AND METHODS: We determined the value of ureteral stents in transplant patients. The frequency of urological complications (leaks, obstructions and urinary tract infections) was compared in a prospective randomized series of 194 kidney transplantations (97 with and 97 without a double pigtail ureteral stent). RESULTS: In the stent group 1 patient had a urinary leak and 35 had urinary tract infections (including 2 cases of Corynebacterium cystitis). In the no stent group 6 patients had urinary leaks, 4 had obstructions and 32 had urinary tract infections. The 1-year patient and graft survival rates were similar in both groups, and renal function at 1 year was also similar (229 versus 208 mumol./l. creatinine in the stent and no stent groups, respectively). A small number of stent related complications occurred (2 stent breakages and 1 stent migration). No stones formed in any case. CONCLUSIONS: Ureteral stent insertion significantly decreases the rate of vesicoureteral leakage and obstruction in renal transplantation.

Adult↗
PubMed1996

[Impact of weight difference between donor and recipient on the function of the transplanted kidney].

OBJECTIVE: The objective of this retrospective study was to determine whether the difference between the donor's weight (wd) and the recipient's dry weight (wr) could influence the function of renal transplants. METHODS: Between 1987 and 1994, 185 patients with a mean age of 43.3 years +/- 12 were transplanted with a locally harvested cadaver kidney, corresponding to 120 men (42.2 years +/- 1.4) and 65 women (45 years +/- 12.8). The weight variation between donors and recipients (wd - wr) was 0.06 for men and 0.22 for women. The serum creatinine of recipients at 1 year was 147 mumol +/- 41.7. We used analysis of variance for univariate statistical analysis and multiple linear regression for multivariate analysis. RESULTS: On univariate analysis, the serum creatinine at 1 and 2 years was significantly higher (p < 0.02 and p < 0.035 respectively) when the donor's weight was 10% lower than the recipient's weight. Multivariate analysis, taking into account the donor's age and sex and the recipient's serum creatinine, confirmed the influence of the donor-recipient weight difference on serum creatinine at 2 years (p0.03), but also the role of the donor's age at 1 and 2 years (p < 0.0001 and p < 0.0004, respectively). CONCLUSION: In our study, the donor-recipient weight difference was a factor influencing the recipient's serum creatinine at 2 years. The donor's age also influences the recipient's serum creatinine, 1 and 2 years after renal transplantation.

Adolescent↗
PubMed1995

Enhanced detection of hematogenous circulating prostatic cells in patients with prostate adenocarcinoma by using nested reverse transcription polymerase chain reaction assay based on prostate-specific membrane antigen.

We report the development of a new sensitive nested reverse transcription-polymerase chain reaction (RT-PCR) assay, using primers derived from the prostate-specific membrane antigen (PSM) cDNA sequence, to detect an hematogenous spread of prostate adenocarcinoma cells. In 60 patients with a biopsy-proven prostate cancer, PSM and PSA RT-PCR detected circulating prostate cells in 40 and 20 patients, respectively. In pT4 M+ and pT3 M+ disease patients, nested PSM primers detected cells in 28 of 33 patients (85%), whereas nested PSA primers detected cells in 17 of 33 (51%). In patients with organ-confined cancer spread (pT2a and pT2b patients) before radical prostatectomy, nested PSM RT-PCR detected circulating prostatic epithelial cells in 6 of 17 patients (35%), which suggests that an hematogenous spread of prostate cells may occur early in prostate cancer history. Altogether, these results suggest that the detection of PSM-expressing cells in blood may predict the development of cancer in patients without clinically apparent prostate cancer. Nevertheless, the potential application and the clinical significance of detection of hematogenous prostate cells through the use of nested PSM primers need an extensive longitudinal study.

Adenocarcinoma↗